1. A Drama2. Whether or not to circumcise?3. Circumcision among Jews3a Ritually3b circumcision on the eighth day4. Circumcision among Christians 5. Circumcision among Muslims6. Female circumcision7. Usefulness and uselessness of circumcision8. Conclusion

1. A DramaAs a teacher of religion I also deal with the rituals associated with Judaism.When I was discussing the circumcision I thought to myself: ‘Let’s take this a step further and also discuss the female circumcision’. I did a little too well: It was too much for a boy in the front and ... he fainted. What a drama! Someone made a minor slip of the tongue with regard to the assignment to Abraham to circumcise: 'You need to have the forehead removed'. Fortunately it only concerns the foreskin... Another one knew what it was like: 'On the 8th day a Jewish boy loses the front house on his penis and he gets a name'. And yet another pupil made of it: 'The circumcision takes place from the 7th day after the birth until the 15th year of life. That seems to me to be too long an operation.

2. Whether or not to circumcise?Besides abortion and shock therapy, circumcision is one of the most controversial medical procedures. There is a conflict between the rights of the child on the one hand, and freedom of religion on the other. What is the medical benefit at all? Circumcision is a relatively simple procedure in which the foreskin of the male genitalia, is removed. This minor medical procedure takes place in a hospital or simply at home. Circumcision is becoming less and less normal worldwide. In the US, the majority (60%, but in the past as many as 90%) of the boys are circumcised mainly because of hygiene. The fact that American boys are circumcised was therefore quite normal and usual. America is the only industrialized country where circumcision was widely practiced for non-religious reasons. It became commonplace at the end of the nineteenth century. In the Netherlands the operation takes place between 10,000 and 15,000 times a year. The reimbursement for a circumcision in boys disappeared from the basic health insurance package on 1 January 2005.

However, under the basic package it is possible to receive reimbursement for circumcision by a medical indication. A circumcision usually costs 265 euros in a special clinic. In a hospital, up to 2000 euros are sometimes charged. Under the supplementary insurance, a number of health insurers offer reimbursement for circumcision without medical necessity. This means that sometimes reimbursement is provided for a circumcision because of religious/cultural reasons. It is possible that no reimbursement will be provided if the clinic/care provider has not been contracted by the health care insurer. Circumcisions may only be reimbursed if there is a medical reason for the surgery. The majority (three quarters) of the 17,000 circumcisions in boys and men each year, take place on religious grounds. The Ministry of Public Health calls it 'not according to the rules', but does not speak of fraud. Supporters and opponents of circumcision have sharpened their knives and take up their positions with all kinds of arguments. The debate in the Netherlands about boys’ circumcision was already initiated in 2010 by the KNMG, the Dutch medical organization. Marcel Poorthuis, Professor of Interreligious Dialogue at Tilburg University, is struck by the fact that the KNMG only takes action against circumcision when it comes to religion.1

Just like ritual slaughter, circumcision has also come under criticism. Opponents of circumcision, such as Patrick van Schie (Director of the Telders Foundation, which is a think tank on behalf of the VVD) and Wouter van Erkel 2 believe that they stand up for the best interests of children. In their view, circumcision of boys is an infringement of the integrity of the human body, indeed an attack on the human body, and in violation of Article 11 of the Constitution. 3 The anti-circumcision action groups 'Intact America' and 'NoCirc' consider the removal of healthy body parts from children who cannot agree to this, to be an ethical problem and campaign vigorously against it. It is striking, however, that these circumcision fighters often do not find it a problem at all to have the same child aborted six months earlier. Also in this case, the child was not asked for permission first... Henk Post, who has a doctorate in Freedom Rights, believes that circumcision is a religious part of the upbringing. The responsibility for the upbringing is primarily with the parents.4 One can also say that the advantages of circumcision are one hundred times greater than the disadvantages. You could compare it to vaccinating and state that it is just as unethical not to routinely offer vaccination and circumcision to parents of a newborn boy. 5

3. Circumcision among Jews3a. RituallyBaby boys are circumcised eight days after birth. Originally this was done with a knife of stone (Ex.4:25, Jos.5:3). This 'Brit Milah' ('covenant of circumcision') stands for the covenant between God and his people Israel. This tradition is even older than the Sinai legislation and is accompanied by blessings. For Jews, this is an important part of the Jewish identity and a normal, natural and religious act, unless the child has health problems. The circumcision can take place at home, in the synagogue, or in the hospital. The 'sandek' (Yiddish Hebrew), also called 'gevatter' or 'godfather' at the circumcision, is the person who keeps the child on his knees during the circumcision as if it were an altar, while the 'mohel' (circumciser) circumcises the child. Two chairs are used, one of which is symbolically intended for the prophet Elijah. Since the end of the nineteenth century, the mohel has been trained by a surgeon. 6

A candidate circumciser may only carry out circumcisions if he has attended at least one hundred circumcisions. The boy loses his foreskin and then gets his Hebrew name, which is pronounced out loud by the mohel. Finally the mohel immerses a cotton ball in a cup of wine and presses it on the lips of the infant. Then he speaks the words of Ezek..16:6 "... and I said to you, while you were in your blood: Live! Stay alive, covered with blood as you are”. And while the mohel 7 puts his hands on the child, he speaks out the wish with those who are present: "May he grow, mature, and become good”. Through this covenant, the newborn becomes a son of the People of the Covenant.8 Often, some proud family members and friends of the parents are invited to this ritual, which ends in a feast. In Yiddish, to circumcise is called ‘yyidyşn’, which means 'making someone to become a full Jew by being included in the Abraham bond'.9

The first biblical person who underwent a Brit Milah was Arch father Abraham, and only at the age of ninety-nine (Gen.17:24). Through the circumcision he is then included in the covenant God made with Abraham. Whoever wants to forbid circumcision, seriously makes the eternal covenant that God made with Israel impossible. A Jew is a member of the covenant with God through birth and not through circumcision. An uncircumcised Jew is also a Jew, although not a 'full Jew'. Circumcision is only a sign which makes visible that it is about a birth covenant. After all, it is a sign to the reproductive organ and, moreover, mainly a sign for the person concerned. No one else should see it. But during the Second World War, quite a few Jewish men had to expose themselves after being forced to lower their trousers. The Nazis abused the circumcision to find out whether someone was Jewish.

For fear of discrimination, harassment and possible new persecution, some parents chose not to have their son circumcised. (For others might discover in the shower after sports that he was circumcised.) On the other hand, there are Jewish men who allow themselves to be circumcised at a later age, because they blame their parents for not having been circumcised as babies. In Judaism girls are absolutely not circumcised, not even among liberal Jews. A girl receives her name on the first Sabbath morning after birth during a service in the synagogue.

3b Circumcision on the eighth dayWhile in the children's clinic 'Adam' in The Hague the circumcision can take place as early as 6 months 10, Jews find this too late. According to Gen.17:10-14 and Lev.12:3 the circumcision must necessarily take place on the eighth day and not only if the child himself can make a choice, but also not earlier than the eighth day. The first days after birth, the liver still has to mature. ‘The reason why babies bleed so easily in the first days is that the important blood clotting elements prothrombin and vitamin K are not sufficiently present. The amount of prothrombin that the baby has in the first days is left over from the mother and on the third day only 30 percent of it is normal. Vitamin K is almost completely absent.’… ‘From the third day on, the amount of usable prothrombin goes up rapidly and reaches a supernormal level of 110% on the eighth day. The amount then drops to normal and remains at the default value of 100% throughout life.

So on the eighth day a baby has more usable prothrombin than on any other day in his life! This means that on the eighth day a bleeding stops faster than at any other moment in his existence.’ 11 Moreover, it has been medically proven that in the foreskin of an eight-day-old boy, the nerves are not or hardly fully grown, so that the child hardly feels any pain'.12 I.e.: the perfect day for a circumcision is the eighth day. ‘An additional reason for circumcision as early as possible is that young children are much less affected by this procedure than adults. It appears that children under the age of three weeks only experience pain and distress at the time of the circumcision itself; after that no longer. Children between four weeks and three months have a maximum of two days of after-pain. Children from three months to one year suffer from three to four days, and adults from more than one week.

Moreover, older boys may sometimes experience a slight trauma from the circumcision, because they experience the procedure as an attack on their body'.13 The fact that the Royal Dutch Medical Association (KNMG) advocates postponing the procedure until the age at which the child can decide on the procedure itself is therefore not advisable on these medical grounds. Jews are not used to knowing the usefulness of a law first, before deciding whether or not to obey it. No, it is written, so they obey. Period. Afterwards God's laws turn out to be very wise and vital. We will search in vain for words like bacteria, infection, contamination, quarantine, incubation period, hygiene and prevention, in the Bible. Although these medical words are missing, it is an issue here. As a motivation for the circumcision God does not indicate that it is good for health and hygiene, but that it is a rite in connection with the covenant, the relationship between God and Israel. For this reason Moses has given you circumcision - not because it is from Moses, but from the fathers [Acts 7:8] - and on the Sabbath you circumcise a man. If a man receives circumcision on the Sabbath so that the Law of Moses will not be broken, are you angry with Me because I made an entire man well on the Sabbath?

Do not judge according to appearance, but judge with righteous judgment." (Jn 7:21-24). The Pharisees endorse circumcision, even if it is on the Sabbath, the day of rest. Thus, circumcision was and is carried out eight days after the birth of a baby boy, and that eighth day sometimes fell on the seventh day of the week, the Sabbath. Nevertheless, circumcision does not violate the Sabbath laws because it is a good deed. According to Jewish law, every man must have been circumcised at the age of thirteen at the latest when he officially becomes the 'son of the commandment' at his bar mitzvah. Although it can be done later, the eighth day is actually always the intention, just as the Lord Jesus Himself was circumcised on the eighth day (Luke 2:21).

4. Circumcision among ChristiansIn the very beginning of Christianity, the question arose whether pagans who had become Christians should be circumcised just like the Jews (Acts 15). The outcome of the first Apostle convention was that believers from the Gentiles did not have to be circumcised. But in the next chapter in Acts (16:3) we read that Paul had his co-worker Timothy circumcised anyway. Timothy had a Jewish mother and a non-Jewish father, and Paul wanted to give the Jews as little offense as possible. Paul was wrongly accused of discouraging Jews living among the Gentiles from circumcising their sons (Acts 21:21). For Christians there is clearly no obligation to be circumcised: "Was any man called when he was already circumcised? He is not to become uncircumcised. Has anyone been called in uncircumcision? He is not to be circumcised. Circumcision is nothing, and uncircumcision is nothing, but what matters is the keeping of the commandments of God" (1Cor.7: 18,19,24). ‘... If you let yourself be circumcised, Christ will be of no benefit to you. I testify again to every man who receives circumcision, that he is under the obligation to keep the whole law" (Gal.5:2,3,6,11, 6:11-17).

Therefore it is not the intention to choose certain laws and leave other ones for what they are. No, it is a (practically impossible, all the more so because the temple has been destroyed, making the temple service impossible) total package of 613 commandments and prohibitions. There are more and more Christians who are fascinated by Judaism (if it exists at all) and even convert to this faith and thus crawl under a yoke. Do they in fact want to be 'more fearful than the pope'? In Reformed churches, before an infant baptism, a baptismal form is read stating that baptism has replaced circumcision, which is based on Col. 2:11: "In Him you were also circumcised with a circumcision made without hands, in the removal of the body of the flesh by the circumcision of Christ.” ‘Without (human) hands' does not refer to a literal ritual, but to symbolism. There are no grounds for a connection between circumcision and Christian baptism (in which human hands are indispensable), nor for a connection between baptism and inclusion in the covenant with God'. So this is nowhere to be found in the Bible. The symbolic circumcision, the circumcision of the heart, applies. According to Rom.2:17-29, Eph.2:11 it is more about the inner circumcision than about the outer circumcision. Abraham (Rom.4) experienced that by faith you are saved, not by circumcision. Inconsistent is that not only baby boys are baptized (usually only sprinkled), but also baby girls, long before they themselves may have come to the stage of discernment.

The fact that baptism would have replaced circumcision is a consequence of the so-called replacement theology (the church has replaced Israel) and is grist to the mill of the national churches. The more (children's) souls the more joy. The sign of the new covenant is not baptism or circumcision, but the cup of the blood of Jesus, which is drunk symbolically in the form of red wine by His followers (Mat.26:28, Mark.14:24, Luke.22:24: "This cup which is poured out for you is the new covenant which is made in My blood").

5. Circumcision among MuslimsAlso in Islam the boys are circumcised, following Abraham and his son Ismael. The circumcision of boys is a ritual that already occurred in Arabia before the emergence of Islam, especially as a hygienic measure. It is called 'Taharah', Arabic for cleansing, cleanliness and circumcision. In Turkish, the circumcision is called 'Sünnet', which is derived from 'Sunna'. And the Sunna is the way Muhammed lived, as is known in the traditions, the Hadith. This term also means 'recommended', and therefore very important for Muslims. Although the ritual of circumcision is not mentioned in the Koran, and is therefore not mandatory, Muslims still see it as a religious duty, because circumcision is the sign that their son is a real Muslim. Circumcision does occur in the Sunna/Hadith of the prophet Muhammed. According to the Traditions Muhammed was born circumcised.14 In contrast to Judaism the age at which this must happen differs from country to country. In Turkey, for example, the age is between two and ten years, but in Morocco it is two years. Boys are circumcised between the seventh day after birth and the fifteenth year of life, at least before puberty. Many parents choose to have their son circumcised at an age when he can experience this festive event, with many gifts for the circumcised one. It is customary among Muslims to circumcise boys before the age of thirteen, because the prophets born after Abraham were also circumcised.

Circumcisie is important for ritual purity. Circumcision can be seen as a ritual cleansing of boys. They acquire a gender identity, become a 'man' and a member of the religious community. A remarkable part of the religious circumcisions among Muslims takes place in the country of origin because it is cheaper there and the ritual aspect plays a more important role than in the Netherlands. However, the quality and hygiene in the Netherlands is much better than in Turkey and Morocco.15 But if a boy does not dare to be circumcised, either by fear of injury or if a renowned doctor has told him that he will suffer from severe bleeding or if the circumcision involves health risks, then the obligation on the circumcision lapses and he commits no sin by not doing it. The validity of a person's conversion to Islam is therefore not dependent on the circumcision being carried out and his acceptance of Islam is valid, even if he does not allow himself to be circumcised. So if a person converts to Islam at an adult age and does not allow himself to be circumcised, there is nothing wrong with that.

6. Female circumcisionFemale circumcision, also known as Female Genital Mutilation, dates from the time of the Pharaohs. At a female circumcision, a better term is ‘genital mutilation’, involves the partial or total removal of external female genitalia. Besides the clitoris, the labia are also removed. In parts of Somalia and Sudan the vagina is stitched, except for a small opening for urine and menstrual blood. Between the symbolic scratch, as in Indonesia, where one drop of blood is enough, and the total removal of clitoris, the small and large labia with the wound edges growing together, there are many intermediate forms. The removing of the foreskin of a boy is really something completely different than cutting away the clitoris and inner labia of a woman! According to the religious authorities in Egypt, this mutilation is necessary to restrict women's sexuality and to prevent nymphomania, infertility and the growth of a penis-like structure (from the clitoris). Infibulation (fibula is 'buckle') is an effective treatment to guarantee the virginity of the girl. At the World Population Summit in Cairo in Sept. 1994, the Egyptian government promised to ban the practice of female circumcision, but soon afterwards withdrew its promise. Religious leaders in that country have made it known that circumcision is a duty for every Muslim woman (however, other Muslim clerics claim that circumcision has nothing to do with Islam).

In Egypt a struggle for power is going on between the emerging fundamentalism and the current regime.16 According to Africans, an uncircumcised woman is unclean and unsanitary. But female circumcision has no religious basis, but is a stubbornly reprehensible cultural practice. For most people, however, it is simply a social obligation, part of an age-old tradition in which women are considered to be calm, caring and above all sexually undemanding. By not participating in this tradition, you risk a scandal and your daughter's chances of marriage will be damaged,' says Vivian Fouad, employee of the National Council for Childhood and Maternity (NCCM). Yet another victim that had to force them in Egypt before they became wise, was the twelve-year-old girl Badoul Shaker who died in a hospital from severe anesthesia in relation to the FGM that had been administered by a doctor.17

The procedure itself is already risky due to the often unhygienic conditions. Think of infections, bleeding to death, scarring of the wound area with pain symptoms, infertility-causing infections, the closure of the parts of the skin with formation of cysts and finally closure of the vagina so that menstrual blood cannot drain off. But it also poses risks at a later age to make the intercourse possible and also, if they are pregnant, a higher risk of complications during childbirth. Then further incision is necessary to lift the constriction. If not, the birth will take a long time and there is a high risk of oxygen shortage for the baby and irreparable injuries to the mother. The pain and humiliation are inflicted with the consent of the mother present and other female family members. This gives a painful feeling of abandonment and rejection.

In circumcised women, sexual dysfunction is more common than in non-circumcised women, as are psychiatric syndromes such as depression, neurosis and phobia. This procedure is also detrimental to the experience of their sexuality. After the birth of the child, the woman often asks (is forced to ask?!) for the labia to be reattached, because her husband just wants a circumcised woman. The size of the vaginal opening, greatly determines the status of the woman. It is not a festive event as is usually the case with the circumcision of boys, but an unannounced, individually applied procedure.18 The reasons given for circumcision are for improving hygiene, promoting social cohesion, preventing promiscuity, increasing the sexual pleasure of the man (How on earth..!) or following religious instructions, but the main reason for this circumcision is preventing a girl from having sex before marriage. In fact, it causes someone else to control another person. The practical benefits are great, at least for the family. The girl remains a virgin and so the dowry is insured.

For some Somali women, re-circumcision (attaching the labia) is culturally almost vital.19 The Kenyan doctor Tatu Kamau, supported by some tribal elders, believes that the ban on female circumcision should be lifted, because it discriminates against women. Why should men be allowed to be circumcised, but not women? He even argues in favor of valuing female circumcision as a 'cultural heritage.19b Although this circumcision cannot be traced back to Islamic norms and traditions, it is mainly Muslim women who have been victims of female circumcision.20 The prophet Mohammed tried to stop the use, which already existed at that time, or at least to have it carried out in a less traumatizing form. Despite all the disadvantages, this tradition is strongly anchored in the culture and social norms of (especially North) Africa: Djibouti, Somalia, Eritrea, Ethiopia, Sudan, Egypt and Guinea, so that almost all women there are still circumcised. Human rights lawyer Anemarie Middelburg, observes that female circumcision occurs among Muslims and among Christians and Jews as well. 21 According to UNICEF, female genital mutilation is indeed the most common in 28 countries in sub-Saharan Africa and the Middle East. More than three million girls and women suffer this painful practice every year.22

Although life-threatening and not for nothing illegal, unfortunately also in the Netherlands, women are genitally mutilated. If these operations are performed amateurishly and non-sterile, the risk of infections and complications is high. According to the GGD (Health organization) in the Haaglanden region, about 5000 girls from these countries between 0 and 18 years old are at risk of being circumcised. In the Netherlands, this illegal practice is regarded as serious child abuse, with a maximum sentence of twelve years.23 The annual 'Zero Tolerance Day' on 6 February 23b, in order to draw attention to this unnecessary painful suffering, is unfortunately no luxury.

7. Usefulness and uselessness of circumcisionFrom a medical point of view, we can weigh up the pros and cons of circumcision. We start with the disadvantages. Male circumcision without anesthesia or local anesthesia is of course painful and can lead to complications: bleeding, infections, urethral stricture, an (abnormal) hole in the urethra, scarification and deformities. A circumcision may later lead to psychological problems such as anxiety, distrust and intimacy problems similar to those after a rape. It is also a violation of the rights of the child. And then we have the advantages. A study by Ugandan and American scientists shows that circumcision greatly reduces the risk of getting infected with sexually transmitted viruses such as herpes or HPV (human papillomavirus is the cause of cervical cancer, genital warts and can play a role in the development of other forms of cancer).

The Prevention of phimosis (tight foreskin) is also a legitimate reason for circumcision. Moreover, circumcision reduces the risk of infection with HIV (the virus that causes AIDS) by 60%.24 Although this procedure is very unusual in Uganda, the men are now queuing up for it. HIV is a major problem in Uganda. Church leaders in sub-Saharan Africa use the circumcision with good intentions as a weapon against HIV/AIDS. However, this weapon is controversial because it also sends a signal that lifestyle is not so important. Dealing responsibly with relationships and sexuality remains a must.25 It is still better and cheaper to prevent than to cure! However, circumcision alone is not enough as a measure to curb the spread of HIV. Circumcision has the additional advantage that the circumcised boys can no longer be sacrificed, because witch- doctors do not consider children who have already bled to be suitable for this purpose.26 Penile cancer is a malignant disease of the penis which is relatively rare in Western Europe. The risk of this penis carcinoma is lower in men who have been circumcised than in men who have not been circumcised.27 Furthermore, circumcision can protect against urethral infections and prostate cancer.

In 2012, the American Academy of Pediatrics concluded that the benefits of circumcising male babies outweigh the risks, but this does not mean that the procedure must be done.28 Of course, the circumciser must be well-trained (not a 'chopper'), work sterile and offer effective pain relief. Does the circumcision have a negative effect on sexuality? Because the glans of the penis is no longer covered, the mucous membrane of the glans of the penis dries out and becomes thicker and insensitive over time. As a result, ejaculation takes considerably longer. For a man this may seem undesirable, but in a marriage this can have the positive side effect that the tempo of man and woman are much closer together.

8. ConclusionIn the case of Jews, circumcision has been essential to their identity for centuries. They can rightly invoke freedom of religion. For Christians, circumcision has ended, except for the symbolic 'circumcision of the heart'. For Muslims it is an important tradition, but not essential. For non-religious people, medical motives play a role in particular. The circumcision of boys and men is not a form of aggression, nor a reprehensible violation of physical integrity. Female circumcision is always reprehensible. It is to be hoped that the above explanation will now enable you to decide for yourself whether to ban, allow or require it.

drs. W.J.A. Pijnacker Hordijk Feb. 2018

translated by Ursula Moestapa

Notes1 Karin Leeuwenhoek, De Besnijdenis, Geloven in Nederland (The Circumcision, Religion in the Netherlands), Sept. 20132 Chairman of the Young Democrats, the youth organization of D66.3 This article states the right to the inviolability of the human body. Everyone can decide for himself what happens to his or her body, what medical actions are performed and what medicines are taken.4 Piet H. de Jong, ‘Overheid moet besnijdenis ontmoedigen’ ('Government should discourage circumcision'), Nederlands Dagblad, 20-5-20175 Mayo Clinic Proceedings http://www.mayoclinicproceedings.org/article/S0025-6196(14)00036-6/abstract ; René Fransen, Besnijdenis is net zo effectief als vaccinatie (Circumcision is as effective as vaccination), Nederlands Dagblad, 3-4-20146 Maarten Vermeulen, Gehecht aan een eeuwenoud gebruik, (Attached to an Ancient Custom), Nederlands Dagblad, Saturday to Sunday Oct. 20047 The mohel keeps all the foreskins and when he dies he takes the foreskins with him into his grave. Every part of the body has to be buried again.8 Loek Keller, De zin van de joodse rituelen (The usefulness of Jewish rituals), Vision 17-23 July 19839 Rabbi S. Ph de Vries, Joodse riten en symbolen (Jewish rites and symbols), (Amsterdam: Arbeiderspers, 1968 ) (3rd edition) p. 19210 https://www.adamkinderkliniek.nl/informatie-over-besnijdenis-kliniek/algemeen/de-ideale-leeftijd-voor- besnijdenis/11 Ben Hobrink, Modern Science in the Bible The Bible is science 3500 years ahead (Hearing: Gideon, 2005) pp. 77, 7812 According to prof. mr. H. Loonstein in K. van der Zwaag, Ingreep in scheppingsdrift van de mens (An intervention in the creative urge of man), Reformatorisch Dagblad, 13-7-200613 J. Katz, The Question of Circumcision, International Surgery, Vol 62 (1977), p. 491 quoted in Drs. Ben Hobrink, Modern Science in the Bible The Bible is science 3500 years ahead (Hearing: Gideon, 2005) pp. 77-7914 According to tradition Muhammad was born without a foreskin (aposthetic). http://www.bbc.co.uk/religion/religions/islam/islamethics/malecircumcision.shtml15 Roderick Schmitz, surgeon in the Groene Hart Hospital in Gouda, working for the Circumcision Centre Netherlands. Jan ten Harmsel, Jongensbesnijdens (Male circumcision in many cultures is essential, Nederlands Dagblad, 28-5-201016 Dina Ezza/Panos, Egypt withdraws promised ban on female genital mutilation, Monthly magazine of the Development Cooperation Information Service of the Ministry of Foreign Affairs, Sept. 199517 Edward Padberg, Egypt complete ban on female genital mutilation, Trouw, 6-7-200718 Gynaecologist M.M.J. Reyners worked in Tunisia from 1972-1976. Source? Only improving the position of women can prevent excesses of circumcision, March. 1990.19 Wilma Kieskamp, 'The question is whether the doctor may mutilate a woman', Trouw, 18-4-1991.19b Tilly Dodds, A doctor in Kenya: lift the ban on female genital mutilation, Nederlands Dagblad, 7-2-201820 See for example Kate McCord, In the land of the blue burkhas (Apeldoorn: De Banier, 2013).21 Rien van den Berg, Female circumcision will stop, but not yet in 2030, Nederlands Dagblad, 16-3-201622 https://www.unicef.be/nl/over-unicef/onze-7-actiepunten/bescherming/vrouwenbesnijdenis/ According to the UNFPA population fund: even 3.9 million girls, which will rise to 4.6 million by 2030 due to population growth.23 Angelique Mulders, The Fight against genital mutilation, Algemeen Dagblad, 4-7-201723b 'International Day of Zero tolerance for female Genital Mutilation'.